Speaking of our coming congressional debates about food stamps and waste, I've been looking for a reason to share Kerry Drake's column about Utah's Housing First initiative. Eight years ago, under Gov. Jon Huntsman, Utah started an experiment in which chronically homeless people—first 17, then 2,000—were given apartments and full-time caseworkers. The goal: Instead of shrugging and cursing when the homeless showed up half-dead at emergency rooms, they'd try to get them into shelter and, hopefully, independent living. If that didn't work, they'd still keep the apartments.

A San Francisco study found that placing homeless people in permanent supportive housing reduced their emergency room visits by more than half. In 2006, the Denver Housing First Collaborative published a study of chronically homeless individuals, comparing the costs of services for two years before and after placement in permanent supportive housing. The group found a 34 percent reduction in ER costs and inpatient nights declined 80 percent.

Anyone who lives in or visits San Francisco might chortle at that, because it's easy to find the chronically homeless wandering around busy parts of the city. That's not the point. Utah gave their Housing First subjects housing, which cost money, in the hopes that they'd save money later. A kind of insurance plan. Utah's own calculations suggested that the state would pocket $5,000 a year by putting the homeless in apartments, instead of hoping they didn't end up in hospitals.

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The longer we talk about hospital ER costs, the more likely we're going to eventually hear more and more conservatives call for an end to compulsory ER care for indigent patients. Just wait for it. More...